公开(公告)号：US06783491B2

公开(公告)日：2004-08-31

申请号：US10173220

申请日：2002-06-13

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC: A61B100

CPC classification number: A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

Abstract: Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube, a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

Abstract translation: 提供了设备和方法，用于将诊断或治疗仪器放置并行进在曲折或无支撑的解剖结构的中空身体器官中，包括手柄，外套管，具有无创尖端的远侧区域。 外套管可以从手柄移除，并且具有相对于把手以一定角度设置的纵向轴线。 外套管可以选择性地加强，以减少由诊断或治疗仪器的前进引起的器官膨胀。 远端区域允许由诊断或治疗仪器的偏转引起的外套管的被动转向，而无创伤的尖端在操纵诊断或治疗仪器期间防止器官的壁被卡住或夹住。

公开(公告)号：US08992420B2

公开(公告)日：2015-03-31

申请号：US13597072

申请日：2012-08-28

Applicant: Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

Inventor： Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

IPC: A61B1/00 ,  A61B1/005 ,  A61B1/018 ,  A61B1/05

CPC classification number: A61B1/0051 ,  A61B1/00085 ,  A61B1/00089 ,  A61B1/00098 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/05

Abstract: Methods and apparatus for off-axis visualization are described herein. An endoluminal tissue manipulation assembly is disclosed which provides for a stable endoluminal platform and which also provides for effective triangulation of tools. Such an apparatus may comprise an optionally shape-lockable elongate body defining a longitudinal axis and adapted for endoluminal advancement in a patient body, at least one articulatable visualization lumen disposed near or at a distal region of the elongate body, the at least one articulating visualization lumen being adapted to articulate off-axis relative to a longitudinal axis of the elongate body, and at least one articulatable tool arm member disposed near or at the distal region of the elongate body, the at least one articulatable tool arm member being adapted to articulate off-axis and manipulate a tissue region of interest.

Abstract translation: 本文描述了用于离轴可视化的方法和装置。 公开了一种腔内组织操作组件，其提供稳定的内腔平台，并且还提供工具的有效三角测量。 这种装置可以包括限定纵向轴线并且适于在患者体内进行腔内前进的可选形状可锁定细长体，至少一个可伸长的可视腔，其设置在细长体的远端区域附近或位于该远端区域处，该至少一个铰接可视化 内腔适于相对于细长主体的纵向轴线偏轴关节，以及设置在细长主体的远侧区域附近或其附近的至少一个可铰接工具臂构件，所述至少一个可铰接工具臂构件适于铰接 离轴并且操纵感兴趣的组织区域。

公开(公告)号：US08911366B2

公开(公告)日：2014-12-16

申请号：US13347897

申请日：2012-01-11

Applicant: Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

Inventor： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

IPC: A61B1/32 ,  A61B17/34 ,  A61B17/02 ,  A61B17/00

CPC classification number: A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

Abstract: A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.

Abstract translation: 外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。 该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。 该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂 ，从而提供手进入空腔。

公开(公告)号：US08906038B2

公开(公告)日：2014-12-09

申请号：US13033485

申请日：2011-02-23

Applicant: Richard C. Ewers ,  Eugene G. Chen ,  Tracy D. Maahs ,  Stuart Moran ,  Cang C. Lam

Inventor： Richard C. Ewers ,  Eugene G. Chen ,  Tracy D. Maahs ,  Stuart Moran ,  Cang C. Lam

IPC: A61B17/10 ,  A61B17/08 ,  A61B17/04 ,  A61B17/42 ,  A61F5/00 ,  A61B17/00 ,  A61B17/06 ,  A61B17/29

CPC classification number: A61B17/04 ,  A61B17/0487 ,  A61B17/42 ,  A61B2017/00349 ,  A61B2017/00818 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0464 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2926 ,  A61F5/0083

Abstract: Devices and methods for forming and securing tissue folds and elongated invaginations in gastric tissue are used as a treatment for obesity. In several embodiments, a plurality of tissue folds is formed along the greater curvature of the stomach using laparoscopic tissue anchor deployment devices. Additional embodiments include various combinations of tissue folds, elongated invaginations, and other reconfigurations of stomach tissue using laparoscopic devices or laparoscopic devices in combination with endoscopic devices.

Abstract translation: 用于在胃组织中形成和固定组织褶皱和细长凹陷的装置和方法用作肥胖症的治疗。 在几个实施例中，使用腹腔镜组织锚定部署装置沿着胃的较大曲率形成多个组织褶皱。 另外的实施例包括使用腹腔镜装置或腹腔镜装置与内窥镜装置组合的组织折叠，细长凹陷和胃组织的其它重新配置的各种组合。

公开(公告)号：US20140214079A1

公开(公告)日：2014-07-31

申请号：US13815110

申请日：2013-01-31

Applicant: Richard C. Ewers ,  Eugene G. Chen

Inventor： Richard C. Ewers ,  Eugene G. Chen

IPC: A61B17/04

CPC classification number: A61B17/0401 ,  A61B1/00183 ,  A61B1/008 ,  A61B17/0057 ,  A61B2017/00663 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0475 ,  A61B2017/0496 ,  A61B2017/06052

Abstract: Methods for percutaneous hernia repair may include inserting a needle end of an anchor tool through a first tissue edge on a first side of a hernia defect opening. A first anchor is deployed with a first suture attached to the first anchor and running back through or along the anchor tool and outside of the patient's body. The needle end of the anchor tool is withdrawn from the first tissue edge. The first suture is separated from the anchor tool. The needle end of an anchor tool is inserted through a second tissue edge and a second anchor is deployed, with a second suture attached to the second anchor and running back through or along the anchor tool and outside of the patient's body. The sutures are tensioned and cinched or knotted.

Abstract translation: 用于经皮疝修补的方法可以包括将锚固工具的针端插入到疝缺损开口的第一侧上的第一组织边缘。 部署第一锚固件，第一缝合线附接到第一锚固件并且沿着锚固工具并且沿着锚固工具向外延伸并且在患者身体外部延伸。 锚固工具的针端从第一组织边缘排出。 第一缝合线与锚固工具分离。 锚固工具的针端插入穿过第二组织边缘并且第二锚固件被展开，其中第二缝合线附接到第二锚固件并且通过锚固工具或者沿着锚固工具返回到患者身体的外部。 缝合线张紧，打结或打结。

公开(公告)号：US08726909B2

公开(公告)日：2014-05-20

申请号：US11342288

申请日：2006-01-27

Applicant: John A. Cox ,  Tracy Maahs ,  Richard C. Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

Inventor： John A. Cox ,  Tracy Maahs ,  Richard C. Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

IPC: A61B19/00 ,  A61B17/10

CPC classification number: A61B17/1114 ,  A61B17/29 ,  A61B2017/00278 ,  A61B2017/00349 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/1103 ,  A61B2017/1125 ,  A61B2017/1142 ,  A61B2017/2905 ,  A61F5/0083 ,  A61F5/0086

Abstract: Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alternative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

Abstract translation: 描述了先前进行的失败的肥胖程序的腔内修复的方法和装置。 一个或多个腔内器械可以每次口服进入先前形成的失败的小袋，其中可以执行许多不同的程序。 可以形成和固定一个或多个组织折叠以减小小袋的尺寸，或者使用内腔部署的组织锚固件将小袋连接到肠道的造口减小。 这些程序可以完全从袋内腔或袋的外表面通过仪器经腹进入患者的腹膜腔进行。 或者，袋内的内部组织可以被损伤或硬化以收缩袋腔。 在另一个替代方案中，Roux肢体的长度可以被内缩缩以产生吸收不良区域。

公开(公告)号：US20130217973A1

公开(公告)日：2013-08-22

申请号：US13765278

申请日：2013-02-12

Applicant: Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V. Taylor ,  Gary R. Dulak ,  Michael J. Dunn ,  Norman L. Morales ,  Charles C. Hart ,  Robert R. Bowes

Inventor： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V. Taylor ,  Gary R. Dulak ,  Michael J. Dunn ,  Norman L. Morales ,  Charles C. Hart ,  Robert R. Bowes

IPC: A61B1/32

CPC classification number: A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

Abstract: A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter through body cavities of varying thicknesses. The retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound, a second ring having a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound, and a sheath disposed between the two rings. Optionally, the second ring may be detachably attached to the sheath to adapt the retractor to body cavities of varying thickness. Additional rings may be disposed along the sheath to provide for adjustment of the distance between the first and second rings. The retractor may also include an expandable foam annulus that can adjust the distance between the first and second rings.

Abstract translation: 外科伤口牵开器适于通过不同厚度的体腔将可伸展到期望直径的伤口扩张。 牵开器包括第一环，其直径大于伤口所需的直径，并且适于在伤口内部配置，第二环的直径大于伤口所需的直径，并适于在伤口的外部进行配置;以及 设置在两个环之间的护套。 可选地，第二环可以可拆卸地附接到护套以使牵开器适应变化厚度的体腔。 可以沿着护套设置附加的环以提供第一和第二环之间的距离的调整。 牵开器还可以包括可调节第一和第二环之间距离的可膨胀泡沫环。

公开(公告)号：US08308710B2

公开(公告)日：2012-11-13

申请号：US10491657

申请日：2002-08-29

Applicant: Jaime Landman ,  Ralph V. Clayman ,  Richard C Ewers

Inventor： Jaime Landman ,  Ralph V. Clayman ,  Richard C Ewers

IPC: A61M25/00

CPC classification number: A61M25/007 ,  A61M25/0032 ,  A61M25/0041 ,  A61M25/0068 ,  A61M27/008 ,  A61M31/00 ,  A61M2025/0004 ,  A61M2025/0034 ,  A61M2025/0073 ,  A61M2025/0681 ,  A61M2205/3331 ,  A61M2210/1082

Abstract: A high-flow low-pressure irrigation system for directing a fluid to and recovering the fluid from an area within a body, the irrigation system comprising a sheath defining a sheath lumen and a flexible catheter disposed in and through the sheath lumen. The catheter defines a catheter lumen and comprises a plurality of apertures at a distal portion that curls in a pigtail configuration. The fluid is directed and outputted to the body area through the catheter lumen and the apertures, and the outputted fluid is recovered and returned through the sheath lumen.

Abstract translation: 一种高流量低压灌溉系统，用于将流体引导到体内的区域并从其中回收流体，所述灌溉系统包括限定护套管腔的护套和设置在鞘腔中并穿过鞘管腔的柔性导管。 导管限定导管内腔，并且包括在末端部分处以辫状构型卷曲的多个孔。 流体通过导管腔和孔被引导并输出到身体区域，并且输出的流体被回收并通过鞘管返回。

公开(公告)号：US20120283756A1

公开(公告)日：2012-11-08

申请号：US13479991

申请日：2012-05-24

Applicant: Scott Moonly ,  John Cox ,  Richard C. Ewers

Inventor： Scott Moonly ,  John Cox ,  Richard C. Ewers

IPC: A61B17/00 ,  A61B17/03

CPC classification number: A61B17/0401 ,  A61B17/0487 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00818 ,  A61B2017/0409 ,  A61B2017/0417

Abstract: Devices and methods for endolumenally manipulating stomach fundus tissue alter the function of nearby nerves. The altered function of the nerves interacts with the cardiopulmonary system to cause a substantially permanent reduction in blood pressure. The altered nerve function may also treat heart disease as well. This application also relates to devices and methods for endolumenally manipulating stomach tissue to alter hormone production from cells associated with stomach tissue, providing a therapeutic effect in treating hypertension and heart disease, not conventionally associated with the stomach.

Abstract translation: 腔内操作胃底组织的装置和方法改变了附近神经的功能。 神经的改变功能与心肺系统相互作用，导致血压基本上永久性降低。 改变的神经功能也可以治疗心脏病。 本申请还涉及用于腔内操作胃组织以改变与胃组织相关的细胞的激素产生的装置和方法，在治疗高血压和心脏病方面提供治疗效果，而不是常规地与胃相关。

公开(公告)号：US08298291B2

公开(公告)日：2012-10-30

申请号：US11412261

申请日：2006-04-26

Applicant: Richard C. Ewers ,  Cang C. Lam

Inventor： Richard C. Ewers ,  Cang C. Lam

IPC: A61F2/02

CPC classification number: A61B17/29 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/0482 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00867 ,  A61B2017/0419 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2927

Abstract: Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically by applying thermal energy through at least one suture cutting element disposed along the deployment assembly.

Abstract translation: 本文描述了用于固定和展开组织锚的方法和装置。 组织操作组件可枢转地联接到管状构件的远端。 可重新配置的发射管也可枢转地联接到组织操作组件，组织操作组件可通过可形状锁定的内窥镜装置，常规内窥镜或直接自身进入患者。 第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。 提供了一种展开组件，用于通过一个或多个组织锚固件固定所接合的组织，所述展开组件还被配置为通过沿着所述展开组件布置的至少一个缝合线切割元件施加热能而使所述锚定器在内部或腹腔镜下脱离。